The Church of England has created a new ‘Reimaging Care’ commission to consider the future of ageing and disability. RedQuadrant’s Amber Griffiths summarises the report:

Full report published: see it here.

Some information from the summarised version of the report:

Forward

This is a new commission to change the future of social care. It is a clear Christian vision, calling to rethink attitudes towards aging and disability within every aspect of our society and its aim is to give every person equal dignity, regardless of capacity. The offered vision requires an essential change of priorities and direction. The main changes proposed to the social care system is the long-term aim to make social care a universal entitlement. The commission shows a vision of one-another care, showing we should have a better sense of what we should do for each other in communities and neighbourhoods, find agreements about where different responsibilities lie, and build long-term networks and associations that will allow people to thrive. The development of a National Care Covenant, proposed by the commission, is the beginning of a wider process to make this vision a reality.

Our vision of care and support in England is that:

• Care and support enables people to flourish and live life to the full;
• Access to and funding of care and support is universal and fair;
• How we care for one another reflects loving kindness and empathy;
• Society, including churches, are inclusive of all people, of all ages and abilities; and
• How care and support are delivered promotes mutuality and is based on trust.

Rethinking attitudes:

All the evidence we received – written as well as verbal – suggested the need for a fundamental shift in the way in which ‘care’ is viewed. A greater public acknowledgement is required of the varied ways in which we all need and give care and support at different times in our lives, and a realisation that care is about mutuality rather than dependence. In other words, the language needs to shift from ‘them’ to ‘us’. People need to be viewed as having agency rather than seen as objects of pity. We must also value those who provide care, paid and unpaid.

But these shifts in attitudes to care have to go hand in hand with a challenge to current negative attitudes towards old age, disability, and mental illness. This should involve a cross-party coalition getting behind a large-scale, long-term public campaign to change hearts and minds with church and other faith leaders playing their part.

Rebalancing roles and responsibilities:

• A greater role for and investment in communities to provide universal support and enable participation and inclusion: Many communities (including faith communities) already provide valuable support and care for older and disabled people. Thriving communities are built on mutuality and reciprocity. However, this needs both investment and nurture, especially by local authorities, if it is to be universal and address inequalities. Local government also plays an important role in promoting inclusion and access to transport, housing, and community infrastructure. Local churches and faith communities need to be equipped with the training and resources to provide effective community-based support in partnership with others and in ways that empower people.
• A new deal for unpaid carers giving them practical, financial and emotional support: It is important that unpaid carers can freely enter into caring relationships out of love, not necessity. They need to be better valued and supported, with adequate recognition, rest, and recompense (together with paid or unpaid leave and flexible working arrangements for those who combine caring with paid employment). Nobody should automatically assume the availability of unpaid care, which for many is not an option.
• A stronger role for the state in guaranteeing universal access, providing protection against the costs of care, and defining a framework of entitlements and rights: National government should set out a long-term commitment to introduce a universal entitlement to care and support (on a par with the NHS). Everyone should be able to lead a good life by accessing care and support when they need it regardless of wealth and income. This will require a means of collective funding and pooling of risk, probably with a tariff of care charges established on a national basis. National government will also need to put in place stronger mechanisms to ensure existing legal rights and entitlements are upheld.
• Accepting our mutual responsibility as active citizens: Social care is everybody’s business. We all have a role to play and must contribute (where we can). This means as citizens, being willing to contribute funding through taxation so that everyone, regardless of income and wealth, can get care and support. It means as members of a community, giving time and looking out for others, from small acts of kindness to volunteering more regularly in community support groups. When we or those we love need care and support, it means engaging proactively to shape the care we need and to use budgets wisely.

Redesigning the system:

Piecemeal tinkering with the existing system will not produce the desired result. We need a radical redesign of the system to make it simple, consistent and person-centred.

Early intervention will be delivered through a universal offer of first contact help in the community. Assessments will be simplified, and a budget allocated based on standardised categories of disability as in Germany and Australia. People will have the freedom to shape their care and support and be trusted to manage their budget (or decide who will manage it on their behalf), supported by independent advocacy.

Local authorities will continue to play a role in shaping the services available in an area, particularly where there are gaps. In addition, the challenge of suitable housing needs to be tackled – not least by the Church of England, which could do more (as the Housing Commission has observed) to use its assets and investments to support integrated, community-based housing options. The potential of person-centred assistive technologies to support people in their own homes also needs further exploration and investment.

We urgently need a new approach to care which includes a long-term plan for the recruitment and retention of paid carers as well as the redesign of roles. Their skill and contribution to people’s lives must be valued and given recognition so that social care is regarded as a rewarding career. This has to be accompanied by improved pay, conditions, and training. Recruitment should be based on values and attitudes as well as qualifications and experience.

Conclusion:

Values are the foundation of this new vision for care and support in England. If realised we believe it will transform the lives of all of us, as we share in the benefits of a society where everyone, regardless of age and ability, is able to live a full life. We are not apologetic for the idealism reflected here. But nor are we naïve. We recognise that implementing this vision has costs, that it cannot be the work of government alone, nor will it be achieved in one parliament. It therefore requires a broad coalition, including the Church and leaders of other faiths, to commit to work over the long-term towards this shared vision and make the moral case for change. There remains an urgent need for action to begin immediately.

For further information see the summarised version of the report: https://www.churchofengland.org/sites/default/files/2023-01/Care%20and%20Support%20Reimagined%20A%20National%20Care%20Covenant%20for%20England%20%28Summary%29.pdf

Some other links:

https://www.churchofengland.org/about/archbishops-commissions/reimagining-care-commission

https://www.churchofengland.org/about/archbishops-commissions/reimagining-care/about-reimagining-care-commission

https://www.archbishopofcanterbury.org/news/news-and-statements/care-and-support-reimagined-national-care-covenant-england-0

https://www.mirror.co.uk/news/politics/archbishops-call-radical-redesign-broken-29027203

https://www.local.gov.uk/about/news/we-must-shift-narrative-ageing-and-disability-lga-responds-archbishops-commission-report

https://consent.yahoo.com/v2/collectConsent?sessionId=3_cc-session_fbb40936-7e16-425b-8a9c-fad57021f32d

https://www.theguardian.com/society/2022/dec/30/archbishops-inquiry-to-call-for-better-dementia-support-in-community

https://www.lgcplus.com/services/health-and-care/richard-humphries-hope-for-social-care-will-come-from-outside-government-in-2023-12-01-2023/

https://www.carehomeprofessional.com/breaking-news-church-of-england-demands-15bn-nhs-style-universal-care/

https://www.churchtimes.co.uk/articles/2023/27-january/news/uk/social-care-system-needs-a-clear-vision-says-report-from-archbishops-commission

https://www.theguardian.com/society/2022/jan/07/provide-social-care-on-par-with-nhs-or-education-says-justin-welby

By Andrew Humphreys

Since June 2022 RedQuadrant has been providing consultancy support to the SAVVI project, which is the Scalable Approach to Vulnerability Via Interoperability. SAVVI, funded by DLUHC and hosted by Tameside MDC, aims to introduce data standards into the public sector, particularly local government, for finding and supporting vulnerable people. RedQuadrant consultant Andrew Humphreys is providing “SAVVI Coach” services to the project which includes leading the work with local authorities and the Ministry of Justice to adopt the SAVVI approach and standards, implement a model process, develop contextualised data models and design data use and sharing processes. 

On 11^th November Andrew Humphreys spoke about SAVVI at the 17^th annual iNetwork UK conference in Manchester that was attended by representatives of local authorities, DLUHC and other local government partners from across the country as part of the project’s efforts to see the SAVVI standards and approach broadly adopted by local government. You can watch a video of Andrew speaking about his work on the SAVVI project here: https://vimeo.com/773783757 

Based on success within the local projects that RedQuadrant is supporting, SAVVI is now preparing an application to the Central Digital and Data Office, within the Cabinet Office, to be adopted across Central Government Departments as the mandatory data standards for finding and supporting vulnerable people. RedQuadrant’s work with SAVVI has recently been extended to March 2023 during which time we expect the standards will be deployed by local authorities with which we have been working. 

By Joanne Peters

“Commercial” is a dirty word in parts of local government. The term is synonymous with privatisation, outsourcing, alternative delivery models, and more generally the extraction of profit, embedded in traditional economic thinking. Often, in engaging with council staff many dismiss commercial thinking as irrelevant or only the concern of those in trading arms or commercial teams.

Commercial acumen is defined as an understanding of how industries and businesses work. It’s about knowing what’s going on in the world and analysing the way that it might impact on your chosen sector and company.

Setting aside the profit connotations clearly associated with the word commercial, there is much to be gained by local government from learning from successful commercial thinking to better deliver against local priorities. In fact, such a negative attitude to ‘commercial’ has implications.

Primarily, being commercial means understanding the organisation’s strategy and priorities, where you and your team fit in, and being able to monitor and measure delivery. It is also about having the skills to understand the local system. Commercial insight is a vital part of understanding the role that a council is playing in local markets, e.g. housing, social care or services to schools, and in building successful partnerships across the public sector and VCS. It is also critical to understanding the implications of often volatile external forces.

Local government is resource constrained. Building a more commercial mindset and understanding how the organisation works supports a shift from rationing a scarce resource to maximising the returns from a scarce resource. It means asking the question, ‘how can we use the budget to get the best outcomes for our residents?’ and having the right information and analytical skills to evaluate options.

Much of what local government does is ‘commercial’, from transactions to contract management, and this is no different from wider commercial enterprise. Being commercial here means being efficient and customer-focused.

Rejecting ‘commercial’, or siloing it to specific teams or entities, means rejecting a mindset and set of skills that are critical for local success. Perhaps we need to develop and nurture a ‘local government acumen’, a nuanced version of commercial acumen?

Commercial skills for successful trading

In 2018, research identified that 59.2% of authorities had at least one trading company, and many more operate venues or sell other services on a commercial basis. Where councils have made a strategic decision to operate services on a commercial basis, having the right skills in place to do this is critical. High profile failures of local council commercial entities have highlighted the risks of not having the right skills at the table.

1. Get the governance right. Senior leaders and members need to understand roles and responsibilities and have the skills and experience to discharge these effectively. They need to avoid conflicts of interest and bring in the right commercial expertise (e.g. independent non-executive directors)
2. Sales and marketing. In short, to create profit in an open market you need to create something that someone values enough to buy and to pay you more than it costs to create, produce, sell, and service it. There needs to be an understanding of the market, competitors, and the unique selling point of the services.
3. Commercial finance and legal advice. Making sure robust tax and legal guidance is available as well as the right financial support built on understanding of sales data, costs, and drivers of profit. Council finance systems are typically not designed to understand this, being focused on resource allocation and budget monitoring.

Underlying this as a foundation stone is an entrepreneurial culture, where staff are supported to take measured risks, to learn, to start and stop activities, and respond flexibly to change.

By Jo Peters.

I work with lots of different UK local authorities and I can see that, as a local government finance leader, your inbox is relentless. Pressures are mounting from all sides. Balancing the budget is the top priority. The increasing number of councils that have succumbed to section 114 notices is a constant reminder of why this is. But your challenge is compounded by multiple factors. A few of the biggest headache inducers include continuous uncertainty over funding, changes to the rules which govern borrowing and investing, accounting, reporting and auditing, and the daily frustrations of interacting with creaky systems and often unreliable data quality.

At the same time, the world is changing. Beyond local government, the traditional role of finance managers as ‘masters of the numbers’ has begun to shift. The ONS projects that more than 50% of current finance jobs will be automated within 10 years. Better access to financial information across the organisation will result in less reliance on finance teams and on traditional budget and reporting cycles. Similarly, the growing awareness of environmental and social value will play an increasingly important role in how organisations, including local government, choose to invest and spend.

“When the rate of change inside an institution becomes slower than the rate of change outside, the end is in sight”

Jack Welch, former CEO of General Electric

I have spent the last few months immersed in thinking about the future of finance while studying at the Cambridge University Institute of Sustainable Leadership. Here there is a rapidly increasing shift to a more impactful approach to business, driven by regulation, shareholder and investor pressure, and the demands of civil society. It is projected that over the next 10 years regenerative business models will come to the fore, with organisations committed to the circular economy and applying full cost accounting to all business impact in the environmental, social, and economic spheres[1].

Where is local government on this change curve? For many, there is an awareness that things are changing, but preparing to respond is, unsurprisingly, lingering at the bottom of that very full in-tray. For others, the pressure is more real and new operating models and new ways of working across the organisation have necessitated finance leaders to consider their own return on investment as a finance function and put change into action. I predict that the same shift that is being seen in the corporate sector will need to happen in local government, but the challenges and pressure faced by finance leaders will make this a difficult shift in comparison to more agile organisations.

We think that having the next generation of finance leaders in place is a great way to start to put in place the adaptability, flexibility and resilience that will be needed to navigate this new world and it is something that is possible, despite other pressures. Are you hiring and developing this next generation of finance leaders in your organisation? What should you be looking for? Here are our top five to look out for:

Technical excellence – this is your backbone. Regardless of the digital advances, there will always be a need for technical expertise to understand the numbers, regulations, and tax issues and interpret this for the organisation. The nature of technical expertise will change as there is a shift to a wider definition of value incorporating environmental and social factors.

Commercial acumen – this isn’t about setting up a trading company, this is about understanding how value is created for the community (beyond finance and beyond organisational boundaries) and building this into decision making. For example, in Oldham an asset-based approach was taken to develop a Social Prescribing Innovation Partnership with a consortium of local organisations, investing in community resources and focusing on early intervention.[2]

Systems thinking – you will need an increasing ability to deal with complexity which can be led by diversity of thought and incremental approaches to managing risk. For example, in recognition that service teams are dealing with complex problems and moving targets, there needs to be flexibility and agility in how budgets are used to ensure resources (both financial and human) are directed to the right thing rather than the thing we planned to spend it on. This will require courage in a climate of financial constraint.

Curiosity, empathy, and an open mind – continuously learning, developing, and building relationships within and outside the organisation. Collaboration will be key to addressing the complex problems that we are facing locally, nationally, and globally. Partnership working has failed so often because of poor relationships, mismatched expectations, and imbalanced rewards. Having a team with the skills to engage and learn about others, find common ground with partners, and embrace complexity and change will enable leadership of successful system change[3].

Storytelling – providing engaging, valuable, and influential insight to support purposeful decision making. Turning strategies into stories will inspire and motivate change to such an extent that organisations such as Microsoft, Motorola, Procter & Gamble, NASA, and the World Bank are intentionally training leaders in the art of storytelling. People will always tell stories, this is about setting the narrative and replacing bad stories with good ones.

Do you agree? Does this match what you are looking for? How does your team stack up?

I think this is a conversation worth having and am keen to continue it with those who are grappling with the challenges and questions I started to wrestle with here. We can either do that in the comments below or over a coffee, I’m on joannepetersconsulting@gmail.com

[1] Grayson, D., Coulter, C. & Lee, M. (2018). All In: The Future of Business Leadership. Abingdon: Routledge

[2] https://www.councils.coop/wp-content/uploads/2019/06/Social-Prescribing-Oldham-Council-1.pdf

[3] McKinsey. (2019). Answering society’s call: A new leadership imperative. McKinsey Quarterly, November. https://www.mckinsey.com/business-functions/organization/our-insights/answering-societys-call-a-new-leadership-imperative#